Provider Demographics
NPI:1427205871
Name:NEWELL, LISA M (DDS)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:M
Last Name:NEWELL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8609 2ND AVE
Mailing Address - Street 2:SUITE 403B
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3360
Mailing Address - Country:US
Mailing Address - Phone:301-585-3400
Mailing Address - Fax:301-585-0346
Practice Address - Street 1:8609 2ND AVE
Practice Address - Street 2:SUITE 403B
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3360
Practice Address - Country:US
Practice Address - Phone:301-585-3400
Practice Address - Fax:301-585-0346
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD107861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice